Understanding Why Type 2 Diabetes Can Be Worse in Young People

Many people think of type 2 diabetes (T2D) as an adult disease. But it's on the rise in pre-teens and teens, and research from Dr. Petter Bjornstad and other scientists have illuminated a concerning trend.

“T2D is not only manifesting earlier, but what we’re seeing in adolescence seems to be more aggressive than in older adults," said Dr. Bjornstad, a physician-scientist who is part of the Center for Clinical and Translational Research. “We're seeing individuals in their late teens and early 20s experience heart attacks, strokes, amputations and severe kidney problems.”

He detailed these findings in a study that followed a group of teenagers with T2D from 2011 to 2020. His team is now working to better understand why these complications happen and what we can do about it.

Understanding Why Complications Happen

Dr. Bjornstad believes studying young people going through puberty might help explain how and why T2D complications happen.

“We rarely, if ever, see T2D before puberty,” he said. “But we’re seeing it more and more during or shortly after puberty.”

He believes this could be because:

• Hormones related to puberty can make the body insulin resistant
• The metabolism is less efficient during puberty
• The kidneys nearly double in size and are more vulnerable to injury during puberty, which could help explain T2D-related kidney disease
• Some combination of all of these and other factors

To learn more, his team launched the PANTHER study, which follows kids ages 8-14 during and after puberty, monitoring metabolism, kidney function and other aspects of health. The end goal is to reveal patterns about when and why complications happen, and open the door to treatments to protect the kidney during puberty.

Dr. Bjornstad recently earned additional funding to follow youth of similar age with type 1 diabetes (T1D) as part of this study.

Children with T1D were historically more likely to be underweight, but today, many people with T1D are overweight, may develop insulin resistance and experience similar symptoms to people with T2D.

“We hope to learn more about the metabolic health of people with T1D to protect their hearts, kidneys and other organs over the long term,” Dr. Bjornstad said.

Finding the Right Treatment at the Right Time

Understanding who is at risk for complications is one part of the equation. Dr. Bjornstad is also exploring another crucial question in T2D: Why do two people with similar symptoms respond very differently to the same treatment?

“Right now, I could have two patients of similar age, the same diagnosis, similar blood sugar control, and they respond very differently to the same medicine. Or one experiences serious complications and another doesn’t,” he said.

He is studying blood and tissue samples to dive deep into the cells and molecules behind the disease. This could reveal patterns called biomarkers that could eventually help doctors predict who is at greatest risk for complications and which treatments are most likely to work for each individual.

“Our ultimate goal is the right medicine for the right patient and to intervene as early as possible to change the trajectory and avoid debilitating complications,” Dr. Bjornstad said.

Related Categories

• Diabetes